Consider a medical trainee, in the second year of her medical training, who has made it a point to always show up early to work no matter the situation. She often times stays beyond the end of her shift to help out either her co-residents or juniors. She is having a bad week and uncharacteristically shows up late for rounds in the ICU. As expected, she is castigated in front …
We need to bring back the feel-good factor to medicine
As presidential hopefuls debate health care reform, it is becoming increasingly difficult to distinguish statements rooted in fact from fiction. According to PolitiFact, only 27% of politicians’ media statements regarding health care — whether from Democrats or Republicans — are true or mostly true. Discerning the truth in a growing state of convolution is becoming increasingly difficult. In such a medical and political quagmire, it behooves health care professionals to …
We need physicians who advocate for patients’ best interests
One of my elderly relatives was in line at the grocery store one day and saw the person ahead of him, charging what looked like a cart full of junk food to her food assistance card. My relative was incensed: Why, should his hard-earned tax dollars be used to pay for someone’s Cheetos?
Currently, one in seven Americans receives some kind of government assistance to pay for food. The largest …
What if people were only allowed to use food assistance dollars to buy healthy food?
The Somalian government should be ashamed of condoning the widespread occurrence of female genital mutilation. According to UNICEF, 98 percent of women from the ages 15 to 49 have undergone FGM in Somalia from 2005 to 2014.
As defined by the World Health Organization, FGM is a procedure that removes or injures female genitalia for a non-medical purpose. This procedure has absolutely no health benefits for women. …
Stop FGM: female genital massacre
Many physicians will decide they want or need to make a transition from the practice of clinical medicine to “something else” at some point during their career. Whatever the motivation for their job transition, most doctors appreciate a rational, structured process that enables then to get from where they are to where they want to be. Fortunately, there are some easily accessible resources that can add value to your work/career …
A roadmap for physician career transition planning
Prior authorization — a utilization management (UM) process used by health insurance companies to determine coverage for a prescribed procedure, service, or medication — is now becoming a mandatory requirement by the vast majority of large insurance companies.
While prior authorizations are pursued at the front-end for almost all planned medical services, there has also been a steep increase in denial of payment for services at the inpatient level for both …
The burden of prior authorizations and denials in health care
One of the advantages of practicing clinical medicine, and seeing patients daily for many years, is you develop your own long-term study regarding certain medical health issues. In the area of hypertension, I have been taught by the best since my internship with pioneers such as Eliseo Perez Stable and Barry Materson at the University of Miami affiliated hospitals, Jackson Memorial Program, ensuring that their trainees were up to the …
Do evolving blood pressure guidelines apply to the geriatric population?
I graduated from an international medical school this past spring. I’m currently in the midst of a preliminary year as an internal medicine resident at St. John’s Riverside Hospital in Yonkers, N.Y. Next year, I’ll start my dream residency in anesthesiology at Brown University.
Like many physicians, my journey to medicine has had its share of twists and turns. But my story is slightly different than the …
What I learned from starting medical school in January
The holidays bring friends and family together for celebrations and the chance to reconnect with people we may not see regularly during the rest of the year. But for people who are the caregivers for a parent, spouse, partner, or other family member who is living with Alzheimer’s disease or other forms of dementia, the holidays can be more complicated.
Beyond the stress of continuing to provide care during an especially …
Navigating the holidays when you’re a caregiver for a loved one living with dementia
On the first day of 2019, the reality show Tidying Up debuted. The show features tidying expert Marie Kondo and is based on her international best-seller, The Life-Changing Magic of Tidying Up. The 200-page manifesto details her approach to decluttering homes: discard belongings that don’t “spark joy,” then organize what remains into carefully designated spaces. The philosophy took the self-improvement world by storm, prompting an influx of …
How to KonMari your academic life
There’s a pivotal scene in the 2007 Pixar movie Ratatouille, in which the restaurant critic Anton Ego takes a first bite of the movie’s titular food. He is then whisked back to a moment in his childhood, during which his mom provides love and comfort through a helping of her homemade ratatouille. This scene is a homage to Marcel Proust’s seminal “Madeleine Episode,” as described In Search of Lost Time, published almost …
The scents in the hospital are from diseases you’ll never forget
The pediatrician kept on telling me that everything was fine. What could possibly be wrong? His motor skills were right on time, if not a little early. He even had emerging problem-solving skills. He did things like push a chair up to a shelf to climb up and get what he wanted. Three decades later, he still does clever things that make me question why he is so impaired.
Unfortunately, there …
Patients with severe autism: medical and dental care in the community
A guest column by the American College of Physicians, exclusive to KevinMD.com.
Regardless of specialty, medical practice is challenging in today’s health care landscape.
Increasing demands related to workload and job inefficiencies, an ever-increasing administrative burden, the consuming nature of health information technology, and personal and professional values that often conflict with the expectations of the …
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The afternoon that I went for a walk with Linda* for the first time was one of the moments I’ve been proudest of as a hospice volunteer, odd though that may seem.
I’d first met Linda a few months prior to that, when the late fall and winter light made her and her husband Joseph’s small and cluttered apartment dark in the early afternoons. I was there mainly to visit Joseph, …
Easing a burden, one step at a time
Take 100 patients who are candidates for colorectal screening. We know that a group of them will try to avoid the procedure or postpone it for as long as possible. Evidence of this, for example, would be rescheduling appointments multiple times to later dates.
We also know that among this 100 is another group of people who need a colonoscopy more than others. A family history of cancerous polyps is a …
How predictive analytics help advance population health
One of the least motivating requests I received routinely as a new intern was something like, “… and can we make sure this is a discharge before noon?” I recall a particularly eager nursing manager surveying the resident teams on her unit to gauge our interest in arriving even earlier each morning (5 a.m., perhaps?) in order to prepare potential discharges before pre-rounding. We shared a nice laugh.
The tension between hospital administrators and medical residents
I first became John Dolan’s social worker following his colon surgery, surgery for removal of a very large cancerous tumor, the largest the experienced surgeon said he had ever seen. John was told he had about three months to live. So much for predictions! He lived another 16 months.
To the chagrin of his very large Catholic family, he was one of thirteen children; he was all the time rejecting their …
The indignity of a cancer that takes away bowel functions
There are few things in our health care system that are more unfair than surprise medical bills. Consumers think they have good coverage and are getting treatment in their health plan network only to get a huge unexpected bill in the mail because it turned out that something like the anesthesiologist at their recent surgery wasn’t covered.
How were they to know that? As you’re sitting on the gurney about to …
Compromise vs. greed in ending surprise medical bills
This is one of my favorite times of the year. Thanksgiving dinner with my family, cool air that calls for cute winter clothes, and holiday festivities that invoke the spirit of love and positivity. As we embark on this season, inevitable holiday sales may tempt us more than we can imagine. In order to deal with this temptation and stay within our budgets, we may need a little motivation to …
A physician’s favorite money quotes for the holiday season
The debate over the safety of giving birth at home, both for the mother and for the infant, has continued for years. I’ve written about the issue myself. From time immemorial until about 75 years ago or so, most babies were born at home. Now it’s around 1 percent in the USA, although it’s much higher than that in many Western European countries. The shift to hospital births …
Is it more dangerous for your baby to be born at home?
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